Whārangi 1: Biography
Robb, George Douglas
Surgeon, medical reformer, writer, university chancellor
I tuhia tēnei haurongo e Derek A. Dow, ā, i tāngia tuatahitia ki Ngā Tāngata Taumata Rau i te 2000.
George Douglas Robb was born in Auckland on 29 April 1899, the son of Scottish immigrants Agnes Rough, a former schoolteacher, and her husband, John Robb, a timber inspector, who was later general manager of the Kauri Timber Company. Douglas attended Mount Eden School from 1904 and Auckland Grammar School from 1912 to 1916. Second place in the New Zealand Junior Scholarship list was a prelude to studying medicine at the University of Otago.
After graduating MB, ChB in 1922 Robb was appointed demonstrator in anatomy for one year, then headed to Britain for additional surgical training. In 1926 he gained his FRCS and undertook his first foray into medical politics, as spokesman for the junior medical staff of the East Suffolk and Ipswich Hospital in their dispute with a ‘most active and officious Secretary’. With his career prospects threatened by tuberculosis, which had carried off several family members including his elder brother, Robb returned home in 1928. In Britain he had been working on his thesis for an MD; he completed the requirements in New Zealand and graduated in 1929.
At this time New Zealand doctors who were intent on becoming specialists were expected to serve an apprenticeship in general practice. Robb, however, decided to enter directly into consulting surgical practice. The decision was regarded as presumptuous, but his advanced knowledge of minor surgery, notably the injection treatment of haemorrhoids (a procedure that was practically unknown in New Zealand in 1928), enabled him to gain a toehold.
This precarious beginning was consolidated by appointments as part-time honorary assistant surgeon to Auckland Hospital in 1929 and as the first Auckland divisional secretary of the New Zealand Branch of the British Empire Cancer Campaign Society in the early 1930s. This combination further inflamed relations with his professional colleagues. Robb’s attempt to introduce medical audit, based on the society’s system of correlating clinical methods, was not well received by the hospital’s senior surgeons, whom he graded according to performance. Their disquiet was compounded when Robb contributed four anonymous articles to the New Zealand Herald , criticising Auckland Hospital Board policy. Robb’s actions were seen as unforgivable by all parties. His application for reappointment in 1935 was declined, and he spent the next seven years in the wilderness so far as public hospital work was concerned. During this time he graduated ChM in 1939.
Robb’s failure to be reappointed coincided with his marriage to Helen Seabrook on 6 November 1935 in Auckland. In 1936 Robb sought treatment for his tuberculosis during a research trip to London’s Brompton Hospital for Consumption and Diseases of the Chest. Back in New Zealand his condition worsened during 1937 until, shortly before a scheduled thoracoplasty, his symptoms suddenly disappeared. His recovery gave him ample opportunity to refine his views on medical politics, which were stimulated by the Labour government’s 1938 social security legislation.
Robb’s first substantive work was Medicine and health in New Zealand (1940). It included many themes that he would grapple with over the next three decades: medical education, the hospital system, the relationship between specialists and general practitioners, and the brain drain of doctors to Britain. In 1942 he published a short analysis of the health system on behalf of the New Zealand Institute of International Affairs; it was a topic that would exercise him for the rest of his life.
In 1943 Robb was the driving force in a group of eight like-minded doctors who produced A national health service , which was intended to ‘help make New Zealand an enlightened country’. The authors advocated group practice, with general practitioners and specialists working together in health centres or polyclinics, as the best way forward. Their blueprint included up to six regional health boards centred on base hospitals, and a national health council to oversee the entire structure.
Robb continued to promote his vision for primary and secondary health care for the remainder of the decade. In 1947 he published Health reform in New Zealand and, spurred by the inception of the British National Health Service in 1948, he co-authored, with S. B. Morris, Hospital reform in New Zealand (1949). Increased professional commitments, however, stemmed the flow of words after 1949. Robb had been invited in 1942 to join Green Lane Hospital’s thoracic surgery unit by Chisholm McDowell, a consultant physician, who was also Robb’s own doctor. McDowell’s persuasive tongue overcame the lingering suspicion of Robb in Auckland Hospital Board circles, and under Robb’s guidance Green Lane gained an international reputation as a cardiothoracic surgical centre, founded on teamwork and astute recruitment.
In 1957 Robb recruited Brian Barratt-Boyes, paving the way for New Zealand’s first open-heart surgery. Robb generously encouraged his younger but more experienced colleague to develop the unit further. The rapidity of Green Lane’s development can be partially attributed to advice offered by American surgeons from Johns Hopkins Hospital, who had been stationed in Auckland during the Second World War, and to a government-sponsored trip Robb undertook in 1948 to study heart surgery in Baltimore. He was later (1959) elected an honorary fellow of the American College of Surgeons.
The American presence also helped bring about the introduction of postgraduate medical teaching. Robb’s early publications argued that this was central to the anticipated expansion of New Zealand’s international responsibilities. The first postgraduate course, conducted at Easter 1943, attracted 200 participants rather than the expected 25. Robb became secretary, then chairman, of the resulting Auckland Postgraduate Medical Committee. In 1953 he also initiated discussions that saw the formation in 1956 of the Auckland Medical Research Foundation, triggered in part by the Medical Research Council’s perceived bias in favour of research at the University of Otago Medical School. In 1956 he was made a CMG.
His resignation in 1957 as chairman of the Auckland Postgraduate Medical Committee allowed Robb to devote more energy to undergraduate education. He had been actively involved as a member of various subcommittees since the mid 1940s in the struggle to obtain a second medical school, located in Auckland. From 1959 he chaired the steering committee set up to achieve this. Vice president (later pro-chancellor) of the college council since 1952, Robb was so opposed to the proposed development of the Princes Street site that he spent the Easter of 1957 penning a 59-page booklet, University development in Auckland. In it he argued that Hobson Bay was the most suitable site for the university; he largely focused on the implications for the medical school, approved in principle in 1953, though he anticipated that work might not start for another 15 to 20 years.
Robb’s election as chancellor of the University of Auckland in June 1961 obliged him to reduce his commitment to Green Lane, leaving him free to concentrate on the proposed medical school. These efforts bore fruit when the government formally endorsed its establishment in 1964. Events moved faster than Robb had dared hope, with the first students admitted in 1968 and the building officially opened by the Queen on 24 March 1970.
The winding down of Robb’s surgical commitments was accompanied by increased international recognition. In 1960 he was a Sir Arthur Sims Commonwealth Travelling Professor, appointed to promote medicine within the British Commonwealth, and was knighted. The following year he was elected president of the British Medical Association, which made a rare overseas excursion to hold its annual meeting in Auckland. Robb’s immediate predecessor was Arthur Porritt, a fellow New Zealander and student contemporary.
Robb’s presidential address sketched a vision of co-operation to reduce inequalities of health between Commonwealth countries, with periodic returns to the British ‘Homeland’ to provide refreshment and inspiration. One British Medical Journal editorial described him as a ‘medical statesman moulding the medical services of New Zealand’, and one journal article revealed his enthusiasm for the formation of a Commonwealth medical association.
After retiring in 1964 Robb visited China in 1966 at the invitation of the Chinese Medical Association. The following year he published his autobiography, Medical odyssey. Outside his medical interests he was chairman of the Presbyterian-Methodist-Congregational Foundation. A trip to Britain in 1973 was marred by a heart attack, the result of long-standing coronary heart disease. The following year on 28 April he died suddenly at his Remuera home. He was survived by his wife, two daughters and a son. Helen Robb had remained very much in the background – guarding the temple of home, as Robb put it in his autobiography. She died when Air New Zealand’s Flight 901 crashed into Mt Erebus on 28 November 1979 during a sightseeing trip to Antarctica.
Douglas Robb was regarded by many within New Zealand medical circles as a ‘persistent dissenter’ and a ‘passionate reformer’. Although he was something of an outsider for much of his career, Robb made significant contributions to medical education, cardiothoracic surgery and health research initiatives. It was a mark of his international standing that a series of tributes to his role as a ‘medical statesman’ appeared in the Lancet within a week of his death.